Scheuermann’s Kyphosis: Understanding Symptoms and Treatment Options

Scheuermann’s Kyphosis (also known as Scheuermann’s disease, and sometimes mispronounced as “Sherman disease“) is a structural spinal condition that leads to an exaggerated forward curvature of the upper back. Unlike postural kyphosis, which can be corrected with conscious effort, Scheuermann’s is caused by irregular vertebral growth, leading to a more rigid and pronounced curve. It most commonly develops during adolescence and can lead to discomfort, a hunched over posture, and in severe cases, pain and mobility limitations.

Causes and Diagnosis of Scheuermann’s Kyphosis

While the exact cause of Scheuermann’s Kyphosis remains under investigation, research has established that genetics and abnormal bone growth play key roles. A previous study proposed that the spinal changes seen in this condition are due to increased stress on the anterior (or front) part of the vertebral growth plate. 

Image by Wheeless’ Textbook of Orthopaedics

In the thoracic region or the upper back, the posterior or rear parts of the vertebrae typically grow at a faster rate than the anterior sections. Moreover, taller children, who often bend their trunks more frequently during daily activities, may experience even higher compressive forces. Over time, these forces can cause the vertebrae to develop a wedge-like shape rather than their normal rectangular form, leading to the pronounced forward curvature characteristic of Scheuermann’s Kyphosis.

Clinically, Scheuermann’s Kyphosis is characterized by anterior wedging of 5 degrees or more in three or more consecutive vertebral bodies and the presence of Schmorl’s nodes, which indicate a disruption of the vertebral growth plates where the disc may protrude into the vertebrae. A diagnosis is typically made through a physical exam and imaging tests such as X-rays, which reveal the distinct wedge-shaped vertebrae. 

Scheuermann’s Kyphosis vs. Postural Kyphosis

Scheuermann’s Kyphosis is often compared to postural kyphosis due to their similar symptoms. While both result in a rounded upper back, they stem from different causes and present unique characteristics. Here’s how the two compare:

• Scheuermann’s Kyphosis is structural, meaning the spine physically changes shape and cannot be straightened by posture correction alone.
• Postural kyphosis is caused by poor posture and muscle imbalances. It is flexible and can typically be corrected with exercises and awareness.

If you’re unsure which type of kyphosis you have, a medical evaluation can help differentiate between the two.

How is Scheuermann’s Kyphosis Related to Hyperkyphosis?

Hyperkyphosis is a general term for excessive curvature of the thoracic spine. Scheuermann’s disease is a specific type of hyperkyphosis, distinguished by its structural abnormalities. While hyperkyphosis can result from aging, osteoporosis, or muscle weakness, Scheuermann’s Kyphosis primarily affects younger individuals due to bone development irregularities.

Symptoms and Impact on Daily Life

Symptoms of Scheuermann’s Kyphosis can vary in severity but often include:

• A visibly rounded upper back
• Hunched over posture
• Stiffness and discomfort in the mid-back
• Fatigue, especially after prolonged standing or sitting
• In severe cases, breathing difficulties due to spinal compression

Other symptoms may include reduced flexibility, tight hamstrings, and localized tenderness along the affected vertebrae. While some individuals experience minimal discomfort, others may struggle with chronic pain that affects their daily activities. Psychological effects such as low self-esteem or body image concerns may also arise, particularly during adolescence. In comparison, scoliosis also affects spinal curvature, but in a different manner.”

Treatment Options for Scheuermann’s Kyphosis

Treatment depends on the severity of the curve, symptoms, and age of the patient. Common treatment approaches include:

• Curve-Specific Physical Therapy: While traditional strengthening and stretching exercises can help, curve-specific approaches like the Schroth Method are designed to address the muscular imbalances using specific spine lengthening, breathing techniques and muscle strengthening exercises, making it a better treatment option.
• Bracing: For adolescents with progressive curves, a brace can sometimes prevent further worsening.
• Pain Management: Over-the-counter medications, massage, and posture education can alleviate symptoms.
• Surgery: In severe cases (curves over 75 degrees), spinal fusion surgery may be recommended to correct the curvature and prevent complications.

If you’re experiencing persistent discomfort due to Scheuermann’s Kyphosis, reach out to The ScoliClinic to explore personalized treatment options.

How to Improve Posture and Spinal Health

While Scheuermann’s disease cannot be fully reversed without medical intervention, lifestyle adjustments can help minimize discomfort:

• Regular core and back exercises to maintain spinal strength

Engaging in exercises that target the core and back muscles can provide better support for the spine. Strengthening these areas helps reduce stress on the vertebrae and minimizes pain over time. Some effective exercises include dead bugs, bird-dogs, and modified planks.

• Curve-specific stretching routines to maintain mobility and flexibility

Gentle stretching exercises, such as yoga or targeted mobility exercises, can improve flexibility and ease muscle tightness in the back, shoulders, neck, hips, and legs. Foam rolling and assisted thoracic extensions can also help release tension in the back muscles. Regular stretches designed by a Physical Therapist can help prevent further postural imbalances while protecting your spine.

• Ergonomic seating and proper desk posture to avoid prolonged stress on the spine

Sitting for long periods in poor posture can worsen kyphosis-related discomfort. Using an ergonomic chair, keeping your feet flat on the ground, and ensuring proper desk height can help maintain a neutral spine position and prevent strain. Lumbar support cushions and standing desk options can further promote a healthier posture.

• Consultation with a specialist for personalized treatment options.

Since every case of Scheuermann’s Kyphosis is unique, seeking expert guidance from a physiotherapist trained in Scheuermann’s Kyphosis management or orthopedic specialist can help tailor an effective treatment plan that addresses individual needs and symptoms.

Take the Next Step

Living with Scheuermann’s Kyphosis can be challenging, but with the right treatment and support, you can manage symptoms effectively. If you’re unsure about the best approach for your spine, The ScoliClinic team is here to help. Schedule a consultation today to receive expert guidance on improving your spinal health.

Final Thoughts

By staying proactive about treatment and lifestyle modifications, individuals with Scheuermann’s Kyphosis can improve their quality of life. While the condition may present physical challenges, early intervention, consistent postural awareness, and proper movement strategies can go a long way in maintaining spinal health and preventing long-term complications.

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